Registration Form
Square Dance Tour of the Millenium, Sep 29 - Oct 13, 2011
To register & save your space send your deposit to:
Tom & Gina Crisp, 4231 S. Pauline Lane , Tucson AZ 85730
Need Trip Medical & Cancellation Insurance? We recommend it. We can buy it for you using your credit card. Call for a price quote.
Call Toll Free: 1-800-901-8044
Total tour cost $4,895 per person

$250 due upon registration, $2,500 due Nov 1, 2010, Full payment due June 1, 2011
Passport names must match airline tickets.  Please enclose a copy of the picture page of your passport.


First Names - for you badges		 ____________________________________________________________

Last Names

Street Address

City / State / Zip

Home Phone


Cell Phone

 ____________________________________________________________


E-mail - Please Print CLEARLY
International Departure Airport Codes & Seating Prevenance.
Signatures: I / We agree to the conditions in the brochure and that Travel insurance is available.

Amount Enclosed & Today's Date

Special Requests - Please note below

 Enclosed $______________ Date: ________________________________